Physician
Pinnacles Peds Care, PA
Pinnacles Peds Care, PA was paid $1.25M by Medicaid between Feb 2019 and Dec 2024, across 46 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.
33Billing provider infoPINNACLES PEDS CARE, PA
PALM COAST, FL 32164
PALM COAST, FL 32164
33aNPI1194033753assigned 09/16/2010
33bProvider typePediatrics Physician
28Total paid$1.25M
24GClaims29,985
24DCodes billed46
24AFirst – last monthFeb 2019 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Florida
Rank by total paid#227 of 971
Median peer was paid$238K
This provider vs. median5.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 6,740 | $239K | |
| 2020 | 5,826 | $232K | |
| 2021 | 5,776 | $255K | |
| 2022 | 4,839 | $224K | |
| 2023 | 3,973 | $186K | |
| 2024incomplete | 2,831 | $119K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 28% | 8,695 | 7,827 | $356K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 15% | 2,424 | 2,364 | $194K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 14% | 1,873 | 1,851 | $173K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 13% | 2,025 | 1,989 | $164K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 10% | 2,226 | 2,078 | $129K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 9.9% | 1,369 | 1,342 | $124K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.1% | 4,484 | 4,346 | $52K |
| 90461 | <1% | 575 | 509 | $11K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 147 | 141 | $10K |
| 99384 | <1% | 98 | 98 | $9K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 154 | 147 | $7K |
| 99383 | <1% | 74 | 74 | $7K |
34 more codes
| 90671 | <1% | 56 | $5K | |
| 99381 | <1% | 26 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 140 | $2K |
| 81003 | <1% | 2,032 | $2K | |
| 99188 | <1% | 88 | $1K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 14 | $1K |
| 99382 | <1% | 12 | $983.67 | |
| 90697 | <1% | 69 | $967.50 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 51 | $841.38 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 153 | $707.96 |
| 90670 | <1% | 403 | $611.08 | |
| 85018 | <1% | 395 | $513.91 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 13 | $404.94 |
| 90734 | <1% | 257 | $373.36 | |
| 83655 | <1% | 159 | $357.00 | |
| 90698 | <1% | 206 | $312.13 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 113 | $278.04 |
| 90710 | <1% | 78 | $236.03 | |
| 90744 | <1% | 24 | $222.45 | |
| 90715 | <1% | 54 | $196.87 | |
| 90686 | <1% | 158 | $100.35 | |
| 90651 | <1% | 291 | $70.01 | |
| 90633 | <1% | 189 | $42.03 | |
| 90680 | 0% | 121 | $0.00 | |
| 97802 | 0% | 345 | $0.00 | |
| 90620 | 0% | 93 | $0.00 | |
| 96127 | 0% | 35 | $0.00 | |
| 90696 | 0% | 13 | $0.00 | |
| 92551 | 0% | 39 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 16 | $0.00 |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment | 0% | 107 | $0.00 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 33 | $0.00 |
| 99173 | 0% | 43 | $0.00 | |
| 90658 | 0% | 15 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialVERDEFLOR, VINCENT (DIRECTOR)